Demeclocycline is a semisynthetic tetracycline derived from Streptococcus aureofaciens that is used as an antibiotic, but perhaps more frequently as an inhibitor of arginine vasopressin in the therapy of hyponatremia and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). While demeclocycline has not been linked specifically to liver injury in the published literature, it is an orally available semisynthetic tetracycline and is likely to cause injury similar to that described for tetracycline, oxytetracycline, and doxycycline. Because it is not commonly used, its potential for causing liver injury may not have been fully defined.
Demeclocycline (dem" e kloe sye' kleen) is a tetracycline antibiotic that is used for therapy of mild-to-moderate infections due to susceptible organisms. It is also used off-label as therapy of hyponatremia and SIADH. Its mechanism of action in SIADH is not well understood, but it appears to block the binding of arginine vasopressin (ADH) to its receptor. This inhibition of antidiuretic hormone action causes an increase in the secretion of free water without an accompanying increase in sodium loss, which results in an aquaresis and increase in serum sodium concentration. Demeclocycline is recommended in doses of 600 to 1200 mg daily in two to four divided doses. Demeclocycline is available in tablets of 150 or 300 mg under the commercial name of Declomycin. Common side effects include indigestion, nausea, diarrhea, headahce, dizziness, glossitis and rash.
No reports of liver injury due to demeclocycline have been published. However, demeclocycline is a tetracycline derivative and is likely to cause liver injury similar to other oral tetracyclines. Both hepatitis and liver failure are mentioned in the product label for demeclocycline, but details of the liver injury are not provided. Finally, demeclocycline causes worsening of kidney function in patients with cirrhosis and should not be used for hyponatremia associated with chronic liver disease.
Likelihood score: E* (suspected but unproven cause of clinically apparent liver injury).
References to demeclocycline induced liver injury are provided in the introductory Overview section on the Tetracyclines.
Drug Class: Antiinfective Agents, Tetracyclines
Demeclocycline – Generic, Declomycin®
|DRUG||CAS REGISTRY NO||MOLECULAR FORMULA||STRUCTURE|